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Guaifenesin, Pseudoephedrine, and Codeine


Pronunciation

 (gwye FEN e sin, soo doe e FED rin, & KOE deen)


U.S. Brand Names

 Cheratussin DAC; Codafed® Expectorant; Codafed® Pediatric Expectorant; Guiatuss™ DAC®; Mytussin® DAC; Nucofed® Expectorant; Nucofed® Pediatric Expectorant; Nucotuss® [DSC]


Synonyms

 Codeine, Guaifenesin, and Pseudoephedrine; Pseudoephedrine, Guaifenesin, and Codeine


Generic Available

 Yes


Canadian Brand Names

 Benylin® 3.3 mg-D-E; Calmylin with Codeine


Use

 Temporarily relieves nasal congestion and controls cough due to minor throat and bronchial irritation; helps loosen phlegm and thin bronchial secretions to make coughs more productive


Restrictions

 C-III; C-V


Pregnancy Risk Factor

 C


Lactation

 Excretion in breast milk unknown/use caution


Adverse Reactions

 See individual agents.


Drug Interactions

 See individual agents.


Pharmacodynamics/Kinetics

 See individual agents.


Dosage

 Oral:

Children 6-12 years: 5 mL every 4 hours, not to exceed 40 mL/24 hours

Children >12 years and Adults: 10 mL every 4 hours, not to exceed 40 mL/24 hours


Patient Education

 See individual agents. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Consult prescriber if breast-feeding.


Dental Health: Effects on Dental Treatment

 Key adverse event(s) related to dental treatment:

Codeine: Xerostomia (normal salivary flow resumes upon discontinuation).

Guaifenesin: No significant effects or complications reported

Pseudoephedrine: Xerostomia (normal salivary flow resumes upon discontinuation).


Dental Health: Vasoconstrictor/Local Anesthetic Precautions

 Use with caution since pseudoephedrine is a sympathomimetic amine which could interact with epinephrine to cause a pressor response


Mental Health: Effects on Mental Status

 Guaifenesin may cause drowsiness or dizziness; pseudoephedrine may cause anxiety or restlessness; codeine may cause drowsiness; may cause euphoria, confusion, insomnia, hallucinations, or depression


Mental Health: Effects on Psychiatric Treatment

 Concurrent use with psychotropics may produce additive sedation or lessen the effects of anxiolytics depending on whether the effects of guaifenesin/codeine or pseudoephedrine predominate; concurrent use with MAO inhibitors may result in hypertensive crisis; avoid combination


Dosage Forms

 [DSC] = Discontinued product

Liquid (Cheratussin DAC): Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (480 mL) [sugar free]

Syrup:

Codafed® Expectorant: Guaifenesin 200 mg, pseudoephedrine hydrochloride 60 mg, and codeine phosphate 20 mg per 5 mL (480 mL) [wintergreen flavor]

Codafed® Pediatric Expectorant: Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (480 mL) [strawberry flavor]

Guiatuss™ DAC: Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (480 mL)

Mytussin® DAC: Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (120 mL, 480 mL) [sugar free; contains alcohol 1.7%; strawberry-raspberry flavor]

Nucofed® Expectorant, Nucotuss® Expectorant [DSC]: Guaifenesin 200 mg, pseudoephedrine hydrochloride 60 mg, and codeine phosphate 20 mg per 5 mL (480 mL) [contains alcohol 12.5%; cherry flavor]

Nucofed® Pediatric Expectorant: Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (480 mL) [contains alcohol 6%; strawberry flavor]


International Brand Names

 Benylin® 3.3 mg-D-E (CA); Calmylin with Codeine (CA)


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